Page posted: 12/10/24 | Page reviewed: | Page updated: |
Legal authority | Federally approved BI, CAC, CADI, DD and EW waiver plans, Alternative Care (AC) program (Minn. Stat. §256B.0913), Health Insurance Portability and Accountability Act (HIPAA) |
Unbundling project | This page includes CDCS unbundled service category policy. When a person transitions to the unbundled CDCS service categories, they will use the policy on this page. For information about who must use this new policy, refer to the Dec. 10, 2024, eList announcement. |
Overview | A support planner must comply with the DHS support planner service standards described on this page when providing support planning services. For more information about services and roles, refer to: · CDCS Manual – Unbundled service category: Support planning services.· CDCS – Support planners (unbundled).This page provides information about standards for: · Functions, limitations and philosophy.· Ethics and values.· Service and support planning, implementation and follow-up.· Fostering self-direction and supporting self-advocacy.· Right to privacy.· Diversity and inclusion.· Billing practices. |
Functions, limitations and philosophy | StandardThe support planner must perform support planner services according to established CDCS policy, self-direction principles, federally approved waiver plans and the written work agreement established between the person and the support planner. Requirements for understanding concepts and philosophiesThe support planner should have a basic understanding of: 1. Aging and disability issues and/or health/medical conditions, including: · Community resources.· Funding mechanisms.· Health and safety.· Other service options.2. CDCS policy, including: · Allowable/unallowable expenditures (refer to CDCS Manual – Allowable and unallowable goods and services under CDCS).· Budgets (refer to CDCS Manual – Budgets).· Employment of support workers (refer to CDCS Manual – Unbundled service category: Personal assistance).· Financial management services (FMS) (refer to CDCS Manual – Unbundled service category: FMS).· Person-centered planning principles and processes (refer to DHS – Person-centered practices).3. Consumer-directed service models and philosophy. 4. Minnesota’s publicly funded programs and service systems, including information about: · Basic eligibility.· Community resources for various populations.· Funding.· Medical Assistance (MA) state plan services.· Program characteristics and covered benefits.· Service access and delivery.5. Roles and responsibilities of: · Support planners (refer to CDCS Manual – Support planners [unbundled]).· FMS providers (refer to CDCS Manual – FMS providers [unbundled]).· Lead agencies.· People who receives services.· Any other involved parties.Service requirementsThe support planner must ensure services: · Are provided within the scope of DHS support planner service standards.· Are related to an approved CDCS community support plan (CSP).· Do not duplicate services provided under CDCS required case management.· Do not duplicate other services available to the person (e.g., services provided by certified assessors, FMS providers, Office of the Ombudsman, advocacy organizations, free civil legal assistance with appeals and other direct services covered under Minnesota Health Care Programs).· Help the person comply with DHS policies, waiver regulations and all applicable Minnesota rules and statutes.DocumentationThe support planner must maintain their own documentation related to support planner services for five years in the event of a DHS audit. Assessments and reassessmentsAs a service provider per Minn. Stat. §256B.0911, subd. 3d, the support planner cannot attend a person’s screenings, assessments or reassessments. |
Ethics and values | StandardThe support planner must perform support planner services according to ethical guidelines. Communication requirementsThe support planner must: · Provide accurate information to the person and all applicable parties.· Communicate issues or concerns related to the person’s health and safety with appropriate parties if they have obtained a release of information (if applicable).· Communicate the scope of support planner services, as defined by DHS policy, to the person, professionals and other applicable parties.· Maintain a collaborative, productive and professional working relationship with lead agencies, FMS providers, people who receive services, family members and other professionals as demonstrated by open, cooperative and positively focused communication with all team members.· Represent the person with respect and integrity.Accountability requirementsThe support planner must: · Accept liability for their delivered support planner services.· Develop a procedure for the person to report dissatisfaction with support planner services and inform them of the procedure.· Document fees in a signed, written work agreement approved by the person and the lead agency before services are paid (refer to the billing practices section on this page).· Not be involved directly or indirectly in fraudulent activities.
Note: DHS can revoke a support planner’s certification if they participated in or had knowledge of and did not report a fraudulent activity.· Not restrict a person’s choices or access to services, supports, providers or benefits covered through any payer.· Report conflicts of interest or fraudulent activities that involve private or public funds (including MA funds) to the appropriate authority (i.e., lead agency and/or SIRS).Conflicts of interestThe support planner must avoid actual, potential or perceived conflict-of-interest situations. A conflict of interest is a situation in which a person or organization is involved in multiple interests (financial, emotional or otherwise), one of which could possibly corrupt the motivation of the person or organization. This includes situations where financial or other personal or professional considerations compromise a person’s objectivity, professional judgment, professional integrity and/or ability to perform their responsibilities. This could include financial interests, personal relationships, family relationships, outside activities (e.g., consulting or other business associations) and gifts. Mandated reportingSupport planners are mandated reporters under the Reporting of Maltreatment of Vulnerable Adults Act and Maltreatment of Minors Act. For more information, refer to: · CBSM – Adult protection.· CBSM – Child protection.Professional boundary requirementsThe support planner must: 1. Maintain professional boundaries in the participant-support planner relationship by avoiding dual relationships with people and their families, including, but not limited to: · Giving or receiving gifts.· Having a business relationship with people outside of CDCS support planning services.· Helping the person or family with something outside the scope of support planning services when the support planner does not have the knowledge, competency or training.· Sharing excessive personal information.2. Direct people to the lead agency (i.e., case manager/care coordinator) or other appropriate resources when they request assistance outside of the scope of support planner services. 3. Only perform functions for which the support planner has established competence. 4. Respect and assist people’s choices that include, but are not limited to cultural and/or religious issues related to CDCS. The support planner cannot: · Be the employer of the person or their legal representatives to whom they are delivering support planner services.· Be the parent of a minor child or spouse of the person receiving services.· Contract with independent contractors who are CDCS participants receiving the support planner’s services.· Exploit participant relationships for personal or direct financial gain.· Have any direct or indirect financial interest in the delivery of the services in the CSP beyond support planning (e.g., a person receiving payment to help develop a support plan cannot employ others or hire independent contractors to deliver services and supports, even if chosen by the participant).· Misrepresent their role, position or title to other professionals.· Request or accept payments from the person, their family or others on behalf of the person for any CDCS support planning work that exceeds the lead-agency-approved amounts. |
Service and support planning, implementation and follow-up | StandardThe support planner must facilitate the development, implementation and evaluation of a self-directed plan that supports the person’s values and choices. The CDCS CSP submitted to the lead agency must include required components as outlined in section 4 of the CDCS Lead Agency Operations Manual, DHS-4270 (PDF). RequirementsWhen developing the CSP, the support planner must: · Use CDCS Community Support Plan, DHS-5788A or a format that includes all of the components and information required to authorize CDCS services.· Apply person-centered thinking/planning principles objectively when addressing the person’s goals and preferences.· Ensure the CSP is developed based on assessed needs identified in the person’s assessment.· Help the person develop a quality CSP and submit it to the lead agency for approval once they have completed the plan thoroughly.The support planner’s specific duties are based on the written work agreement established between the person and the support planner. As documented on the written work agreement, the support planner’s tasks might (but are not required to) include helping the person: · Access community resources related to the CSP, as requested.· Implement, monitor and evaluate the approved support plan and budget.· Follow up on any required documentation for goods or services the lead agency has not yet approved, as requested.· Manage their support workers (e.g., selecting, hiring, defining worker tasks, training or monitoring/evaluating), as requested.· Modify their plan as needed, including revisions and addendums, in accordance with DHS policies. |
Fostering self-direction and supporting self-advocacy | StandardThe support planner must teach the person how to self-direct and self-advocate when developing and implementing a plan for CDCS services according to their personal goals and preferences. RequirementsDuring the CSP development process, the support planner should be able to teach the person about: · Core components of developing a quality service plan (e.g., health and safety, emergency back-up plan, personal preferences) within the person’s assessed needs and budget parameters.· Addressing assessed needs with services, goods, equipment, technology and home/vehicle modifications.· Completing tasks independently (e.g., writing, modifying and monitoring their CSP, submitting addendums and supporting documentation to lead agencies, monitoring and managing the budget).· Components of self-advocacy, including personal values, decision-making, problem resolution and communication.· Consequences of potential risks associated with their personal decisions.· Establishing a personal risk management plan to address the consequences of personal decisions and risk.· Establishing safeguards to maintain their health and safety in a reasonable way.· Identifying and addressing issues with fraud and abuse.· Personal choice, flexibility, control and responsibility.The support planner must: · Respect the person’s rights, personal preferences and values, regardless of age, race, ethnicity, gender, sexual orientation, religion or physical or cognitive ability/function.· Understand that the person directs all decisions related to the development and implementation of the CSP. |
Right to privacy | StandardThe support planner must respect and keep all participant information confidential. RequirementsTo maintain the person’s privacy rights, the support planner must: · Comply with state and federal regulations regarding privacy and confidentiality (e.g., HIPAA). · Ensure the use of confidential information is based on best practices, as well as ethical and legal considerations, including HIPAA.· Understand and use authorized releases of information.· Maintain records or documents necessary for authorized releases of information. |
Diversity and inclusion | StandardThe support planner must be knowledgeable about and respectful of the history, traditions, values and family systems of people from various ethnic, cultural, racial, religious, disability and sexual orientation groups. RequirementsThe support planner must: · Assist people objectively and responsively to address cultural, economic, religious and/or sexual orientation disparities to gain access to services and support.· Be capable of accessing resources to communicate with people who have vision and hearing impairments, as well as limited and non-English speaking populations.· Be sensitive to and respectful of the needs, issues and/or networks of people in diverse populations (e.g., older adults, people with disabilities, ethnic groups, new immigrants and people who are gay, bisexual and transgender).· Commit to ongoing education about resources for new population segments.· Have knowledge of the person’s community system and resources available for subsets of diverse populations. |
Billing practices | StandardThe support planner must ensure all services billed are within the scope of the DHS support planner standards. RequirementsThe support planner must: · Ensure services billed match the services performed as found in supporting documentation (i.e., written work agreement, CSP, billing invoices, emails or faxes).· Establish fees based on the community market price of CDCS support planning services and inform the person of the fees.· Include all billable tasks on the written work agreement between the support planner and the person, have the person sign the agreement and submit it to the lead agency.· Obtain approval from the person for itemized invoices for support planner services performed if required by the written work agreement between the person and the support planner.The support planner cannot bill for work/tasks/time: · Before the completion of the work/tasks.· Duplicative of services performed by the lead agency, FMS provider and other direct services covered under MHCP.· Not approved on the CSP.· Not included on the written work agreement.Billing exception for CSP developmentIf approved by the lead agency, a support planner can help develop a person’s CSP before the person’s final selection of CDCS. Under these circumstances, the support planner will receive payment only when the plan is approved, effective the date the lead agency authorizes CDCS services. |
Additional resources | CDCS Manual – Unbundled service category: Support planning services
CDCS Manual – Support planners (unbundled) |
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